Enhancing Quality and Safety – Medication Errors
NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety
Medication administration mishaps are a significant global health issue and the main contributor. It’s difficult to find a continuous source of mistakes, let alone propose a regular plausible solution that reduces the likelihood of a repeat occurrence of medication errors. Patient safety may be enhanced by noticing unfavorable occurrences, understanding the future, and acting to minimize them. Maintaining a mentality that focuses on recognizing safety issues and adopting viable alternatives rather than retaining a fault, humiliation, and retribution mindset is a component of the answer. Medical organizations must ensure a safe attitude that emphasizes modifications to the existing system and views clinical errors as obstacles to be conquered. All healthcare staff must contribute to making medical care better for providers of healthcare and patients (Helo et al., 2017).
There are two categories of mistakes, according to Rodziewicz et al, (2018):
- Omission errors arise when certain activities are not done. Not securing a person into a wheelchair or supporting a stretcher before the patient transfer. The conduct of errors occurs when an incorrect activity is performed.
- Giving a drug to which, a patient is allergic or failing to mark a test item that is later assigned to the wrong patient.
Scenario Related to Medication Errors
Joana, a 26-year-old woman, was admitted to the labor room for the delivery of her child during the midnight shift. Due to extreme labor pains, the patient was prescribed for painkillers before her delivery. The nurse failed to perform a patch test for any allergic reaction as she neglected it on the basis that the patient had no prior history of an allergy to the medicine. However, the patient had developed an allergy to such medicine during her pregnancy and as a result the adverse effects of the medicine almost cost the patient her child. This medication error was due to multiple factors, including negligence to check the patient for an allergy, the incorrect medication, insufficient sleep of the staff, and not updating the patient’s medical chart to the current scenario.
Elements Of Quality Improvement Initiatives
Improvements in quality do have a powerful effect on healthcare outcomes. Improvement in the quality will become more useful and accurate, and productivity will increase. The efficiency of a medical center that adopts traditional procedures and methods will not develop. Upgrades allow healthcare organizations to substitute unproductive procedures and concentrate on more essential issues. For example, shifting to electronic documents for patients’ medical analyses (Baumann et al., 2018). Medical practitioners may use the application to keep a record of stuff as well. For healthcare producers, there seem to be performance management software applications that allow companies to oversee performance and procedure quality and eliminate quality problems through standardization and good practices (Asensi et al., 2018).
Print has always been the most common means of recording details concerning activities in hospitals (Baumann et al., 2018). This raises the risk of forgetting duties, lost or misplaced paperwork, and attempting to arrange things during work transfer at the end of job sessions, which all put people’s lives at risk. If employees transitioned from print to a computerized system, they would have access to all crucial data, which would be maintained continuously and promptly.
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The digitization of managing projects helps employees to recapture hours previously wasted answering the phone and bleeping coworkers for work and clinical records, hence enhancing patient safety. Professionals may successfully organize their load by keeping assignments and sensitive data on a user-friendly system using an electronic system within the organization. Multidisciplinary groups may cooperate and communicate more effectively throughout nursing units with the support of electronic task management, saving extra energy for care coordination (Marvanova et al., 2018).
NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety
Digitalization of facilities, as per NHS’s Patient Safety Strategy, might lead to “momentous breakthroughs” in improving patient safety. Electronic task management systems give employees faster access to essential data alongside authentic changes, enabling them to make smarter choices about patients. Staff is already wasting reduced time responding to bleeps and phone calls from coworkers, according to various adopters of such equipment, letting them devote better effort to taking care of patients and contributing to a better, less hectic environment.
Following are some of the digital software that are being used to decrease medical errors (MEs):
- Radio Frequency Identification (RFI)which decreased MEs by 5.25%
- Computerized Physician Order Entry (CPOE) which decreased MEs by 3.15%,
- Bar Code Assisted Medication Administration (BCAMA) which decreased MEs by 3.15%
- Electronic Medication Administration Record (EMAR) which decreased MEs by 2.10%
The RFI device was found to be an important aid in the “patient identification process” and to prevent medication-related mistakes (Costa, et al., 2017; Alotaibi and Federico 2017; Talyor et al., 2019). Barcode readers were utilized to identify patients and drugs being delivered in the BCAMA and the EMAR, which decreased mistakes by up to 80%. (Costa, et al., 2017 Alotaibi and Federico 2017; Talyor et al., 2019). Due to incomprehensibility, the use of incorrect acronyms, and insufficient information, the CPOE decreased mistakes by 20%. (Costa, et al., 2017 Alotaibi and Federico 2017; Talyor et al., 2019).
Factors That Lead to Patient Safety Risks
A medicinal error is defined as the failure to execute any one of these rights to treatment. A medical mistake in these areas, whether it’s the method, the amount, the medicine, the person, or the timing, can result in serious side reactions that could result in the patient’s harm or death. Other than this, several underlying factors lead to the possibility of a medical error. Some of the most serious issues include reckless behavior by healthcare workers, labor non – availability, insufficient sleep, and environmental problems (Manfredini 2020; Tarhan et al., 2018). Even when the healthcare practitioner is knowledgeable, to some degree, that quality care may be threatened, the seeming benefits of taking a harmful alternative lead to more frequent unsafe behaviors. Moreover, if one healthcare practitioner appears to be successful with a potentially dangerous action, they could most certainly persuade others until the behavior becomes standard. Institutional difficulties within a healthcare facility, such as an administrative attitude that accepts irresponsible behavior, may lead to dangerous activities. Healthcare leaders should assess their companies’ actions regularly. Excessive intricacy in procedures exposes employees to a variety of risks.
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Organizational Interventions to Promote Patient Safety
Nursing professionals have two major roles within quality improvement (QI): they carry out interdisciplinary processes to achieve organizational QI goals and they measure, enhance, and regulate nursing-sensitive indicators (NSI) that affect patient outcomes. At both the personal and organizational level levels, nurses are essential in providing secure, greater care. Nurses have to resolve concerns, make choices, set agendas, and collaborate with other teammates. Nurses must identify and address deficiencies in care that might endanger patients’ health. Nurses are critical to patient safety because they assess patients for a clinical decline, recognize errors and close calls, understand care protocols and system problems, and perform a variety of other tasks (Tariq et al., 2018).
NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety
The healthcare system should prioritize skill development and leadership development.
The demands and challenges of the working crew should be addressed by organizational management, enabling a safe and healthy workplace. The lack of resources must be resolved to offer patients timely, premium therapy. To achieve access to care and successful treatment options, cooperation and human relationship development must be fostered.
Staffing and nursing recruiting can help reduce workload and foster a positive working environment (Kieft et al., 2019). Scheduling by the staff and adaptable timetables can improve patient care by encouraging employees to be more engaged in their work schedules (Boamah et al., 2017). Nurse burnout may be reduced and employee satisfaction increased by improving nurse work efficiency and creating a competent working atmosphere. Programs, courses, organizations, and people can all help to improve work performance (Patel, et al., 2018).
Role of Stakeholders
People or organizations who are concerned about the system’s effects, the evaluation’s results, or what transpires with the evaluation’s conclusions are referred to as stakeholders. Those served or impacted by the service include patients or consumers, advocacy groups, the general public, and elected representatives. Stakeholders include people and institutions such as carers, doctors, advocacy organizations, and politicians. One can help ensure that their quality improvement (QI) activities are successfully managed, produce the best outcomes, and benefit by involving stakeholders. The destiny of the healthcare business is heavily influenced by stakeholders (Elliott et al., 2018). Their help is essential since they provide funding, assistance, plan, remedies, as well as other resources to the health industry overall. Their help is crucial since they provide the necessary funds, expertise, and knowledge to complete the job. They also affect the public’s opinion of predicted costs.
Conclusion
Several management and healthcare-delivery difficulties plague the healthcare system.
The World Health Organization has identified the rising matter of medication administration errors as the highest concern for creating adequate, effective, and patient-centered health care.
Several variables including nurses, administration, and the work conditions obstruct any questionable action among hospital workers. However, under supervision and administration strategies, sustainable wages, interaction, synchronization of members of staff, and personal involvement of nurses may improve health care standards of quality and patient experience.
References
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173. DOI: 10.15537/smj.2017.12.20631
NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety
Asensi-Vicente, J., Jiménez-Ruiz, I., & Vizcaya-Moreno, M. F. (2018). Medication errors involving nursing students: A systematic review. Nurse educator, 43(5), E1-E5. DOI: 10.1097/NNE.0000000000000481
Baumann, L. A., Baker, J., & Elshaug, A. G. (2018). The impact of electronic health record systems on clinical documentation times: a systematic review. Health Policy, 122(8), 827-836. https://doi.org/10.1016/j.healthpol.2018.05.014
Boamah, S.A., Read, E.A. and Spence Laschinger, H.K., (2017). Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time‐lagged study. Journal of advanced nursing, 73(5), pp.1182-1195. https://doi.org/10.1111/jan.13215
Costa, J., Martins de Assis, J., Melo, M., Xavier, S., Melo, G., & Costa, I. (2017).
Technologies Involved in the Promotion of Patient Safety in the Medication Process: An
Integrative Review. Cogitare Enfermagem,22(2), https://doi.org/10.5380/ce.v22i4
Di Simone, E., Fabbian, F., Giannetta, N., Dionisi, S., Renzi, E., Cappadona, R., … & Manfredini, R. (2020). Risk of medication errors and nurses’ quality of sleep: a national cross-sectional web survey study. Eur Rev Med Pharmacol Sci, 24(12), 7058-7062. DOI: 10.26355/eurrev_202006_21699
Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ quality & safety, 30(2), 96–105. https://doi.org/10.1136/bmjqs-2019-010206
Helo, S., & Moulton, C. A. E. (2017). Complications: acknowledging, managing, and coping with human error. Translational andrology and urology, 6(4), 773. DOI: 10.21037/tau.2017.06.28
Kieft, R.A., de Brouwer, B.B., Francke, A.L. and Delnoij, D.M. (2014). How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC health services research, 14(1), pp.1-10.
Marvanova, M., & Henkel, P. J. (2018). Collaborating On Medication Errors in Nursing. The Clinical Teacher, 15(2), 163-168. DOI: 10.1111/tct.12655
NURS FPX 4020 Assessment 1 Attempt 1 Enhancing Quality and Safety
Patel, R.S., Bachu, R., Adikey, A., Malik, M. and Shah, M., (2018). Factors related to physician burnout and its consequences: a review. Behavioral Sciences, 8(11), p.98. https://doi.org/10.3390/bs8110098
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Talyor, Z. B. (2019). Eliminating Medication Errors in Nursing Practice with an Innovative Quality Improvement Tool Proposal. https://commons.lib.niu.edu/handle/10843/21691
Tarhan, M., Aydın, A., Ersoy, E., & Dalar, L. (2018). The sleep quality of nurses and its influencing factors. https://dx.doi.org/10.4103/ejop.ejop_35_18
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